HomeMy WebLinkAboutU15006833 Authorization of Special Billing Form.pdf
Renton City Hall • 1055 South Grady Way • Renton, Washington 98057 • rentonwa.gov
CITY OF RENTON
AUTHORIZATION OF SPECIAL BILLING
January 13, 2016
Forest Contracting, Inc.
27018 233rd Place
Maple Valley, WA 98038
U15006833 – Campbell Short Plat Utilities Installation (PR15‐003111)
It is the intent of this letter to authorize the City of Renton to bill the undersigned for all costs
incurred relative to the referenced project, by the City of Renton for the following work:
TIME AND MATERIALS FOR ANY AND ALL ROAD CLEANUP EFFORTS PERFORMED BY CITY
FORCES OR CITY CONTRACT.
ALL OVERTIME FOR INSPECTION AND RELATED ACTIVITIES, BILLABLE AT A RATE OF
SEVENTY FIVE DOLLARS ($75.00) AN HOUR.
TIME AND MATERIAL FOR ANY WORK DONE BY CITY STAFF TO REPAIR DAMAGES.
TIME AND MATERIAL COSTS INCURRED FOR SECONDARY, INDEPENDENT ENGINEERING
REVIEWS, CONSULTATION AND ON‐SITE INSPECTIONS AS DEEMED NECESSARY BY THE
CITY.
BILLING TO BE SENT TO: (Print Please)
Name:
Company:
Address:
Phone:
Fax:
Owner/Developer or Authorized Agent Date